A Technical Assistance Model Built for Lesotho
Through support from the U.S. government, along with private and multilateral donors, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) works at multiple levels of the health care system to meet the needs of women, children, adolescents, and families affected by HIV.
As a global leader in health service provision, EGPAF was chosen by the U.S. Agency for International Development (USAID) to enhance the technical, clinical, and programmatic capacities of local partner organizations – as part of the Providing Universal Services for HIV/AIDS (PUSH) project.
To strengthen local capacities, EGPAF provides tailored, evidence-based technical assistance (TA) at the facility, community, district, and national levels. Implementing partners throughout Lesotho are empowered to achieve programmatic goals, deepen their technical expertise, establish and enhance professional networks and local support systems, and progress toward USAID’s strategic goal of self-reliance.
This comprehensive, sustainability-focused model scales up national care and treatment programs through high-impact TA activities that strengthen capacity in numerous areas, including:
Health systems strengthening
Strategic information and evaluation
Quality improvement and assurance
Community engagement
Project management
HIV service delivery
EGPAF’s Model for Local Capacity Building: An Iterative Process
Though technical support for local implementing partners (LIPs) is key, it is just one part of EGPAF’s larger capacity-building model. Powered by a central learning community, this integrated approach has three major components:
- Using technical assessments to determine partner capacities
- Using action plans to operationalize results
- Providing high-quality TA that is tailored to the unique needs of each organization
Training of Trainers
EGPAF works with national, regional, and international subject matter experts to develop the technical toolkits used for this intervention. As evidence-informed resources, toolkits draw from a comprehensive curriculum whose scope can be adjusted to address challenges specific to each implementing partner’s context.
Moreover, they allow training sessions to be held both virtually and in person – providing crucial flexibility during the ongoing COVID-19 pandemic. For maximum efficacy, training participants are selected based on their ability to teach and disseminate information across teams.
See how a tailored technical training curriculum helped Matrix scale up its TB screening services.
Disseminating Knowledge and Skills
Local partners also receive a standard operating procedure (SOP) that helps them conduct step-down trainings, makes evidence-informed recommendations, and improves their change management systems overall. In this way, EGPAF ensures that the learned skills permeate the entire organizational structure.
Supportive Supervision
Supportive supervision by the EGPAF project team is the main line of communication between the local organization and EGPAF aimed at improving quality of care through joint observation, discussion and direct problem solving. The routine check-ins and visits maintain a strong relationship with the local organization that builds trust and affords the EGPAF project team insight into how best to support the local organization to achieve its operational and technical capacity goals.
Supportive supervision is provided by people who remain consistent to the local organization throughout the project life cycle. Consistency in the supervisory structure encourages relationship and trust building between the local organization and EGPAF. Through this relationship, the project team is able to learn more about the local organization’s weakness and challenges, which helps EGPAF to coordinate better TA and provide guidance on how to address capacity needs.
Mentorship
Mentorship is the TA provided to local organizations in their prioritized areas of need to foster on going professional and/or clinical development. Mentorship comes from across the EGPAF office, depending on the specified needs and priorities of the local organization. Mentorship guides the local organization in the application of new skills and tools for growth in specific capacity areas.
While the structure and style of mentorship varies across EGPAF providers and capacity areas, the focus is on skill building and empowering the local organization to create and own its organizational systems.
To build local organization competencies, TA is done in a stepwise process that improves local organization staff knowledge and puts it into practice. Designated local organization members work with the TA provider, who mentors them to create and own the work, and ensure that their organization’s culture and processes are documented. The application of new skills or use of new resources that are easily understood supports good change management across the local organization.
Advocacy and Networking: Building Local Support Structures
Local partners are slated to play a greater role in program implementation and service delivery in the national HIV and TB responses of the future. To achieve this, civil society organizations (CSOs) must be more meaningfully involved in national and international forums. EGPAF advocates for CSO integration that is evidenced by: participation in national level working groups, policies designed to secure continued engagement, and a shared vision of CSO involvement that is adopted by all stakeholders.
EGPAF aims to create an enabling environment marked by professional networks of support. In practice, this means availing opportunities for international organizations and local partners to share knowledge. This inter-organizational learning community can avail ideas that lead to significant breakthroughs, as Baylor-Lesotho discovered in its efforts to extend PrEP services to a key population. Most importantly, these learning networks embody the principles of growth, sustainability, and mutual benefit
